MEDICARE: KATHERINE CELESTE GRIFFIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	18924	NC
2	101YM0800X	Mental Health Counselor	18924	NC
3	101YP2500X	Professional Counselor	18924	NC

General Provider Information

NPI Number	:	1558142273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE CELESTE GRIFFIN

Provider Business Mailing Address
First Line	:	16507 NORTHCROSS DR STE F
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-5082
Country	:	US
Telephone Number	:	770-298-1667
Fax Number	:	980-999-4058

Provider Business Practice Location Address
First Line	:	16507 NORTHCROSS DR STE F
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-5082
Country	:	US
Telephone Number	:	980-999-4006
Fax Number	:	980-999-4058

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	03/17/2026

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